80810 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Notices 

programs and airport sponsors receiving 

financial assistance for expenditures of 

Federal funds on acquisition and 

relocation payments and required 

services to displaced persons that are 

subject to the Relocation Assistance and 

Real Property Acquisition Policies Act 

of 1970, as amended, for file 

maintenance and for annual statistical 

reports. 

Estimated Average Burden per 

Response: The respondents 

electronically submit one statistical 

report each year. The average burden 

per statistical report is 16.5 hours. Each 

instance of file maintenance requires an 

estimated average of 30 minutes to 

complete. 

Estimated Total Annual Burden 

Hours: Total estimated average annual 

burden is 25,000 hours. 

Public Comments Invited: You are 

asked to comment on any aspect of this 

information collection, including: (1) 

Whether the proposed collection is 

necessary for the FHWA’s performance; 

(2) the accuracy of the estimated 

burdens; (3) ways for the FHWA to 

enhance the quality, usefulness, and 

clarity of the collected information; and 

(4) ways that the burden could be 

minimized, including the use of 

electronic technology, without reducing 

the quality of the collected information. 

The agency will summarize and/or 

include your comments in the request 

for OMB’s clearance of this information 

collection. 

Authority: The Paperwork Reduction 

Act of 1995; 44 U.S.C. chapter 35, as 

amended; and 49 CFR 1.48. 

Issued On: November 14, 2023. 

Jazmyne Lewis, 

Information Collection Officer. 

[FR Doc. 2023–25537 Filed 11–17–23; 8:45 am] 

BILLING CODE 4910–22–P 

DEPARTMENT OF TRANSPORTATION 

National Highway Traffic Safety 

Administration 

[DOT–NHTSA–2023–0037] 

Emergency Medical Services 

Education Agenda 2050: Request for 

Information 

AGENCY: National Highway Traffic 

Safety Administration (NHTSA), 

Department of Transportation (DOT). 

ACTION: Reopening of comment period. 

SUMMARY: NHTSA published a request 

for information on October 13, 2023, 

seeking comments from all sources 

(public, private, government, academic, 

professional, public interest groups, and 

other interested parties) on the planned 

re-envisioning of the 2000 EMS 

Education Agenda for the Future: A 

Systems Approach. Due to the limited 

comments received and some informal 

feedback indicating that the initial 

comment period was too short, NHTSA 

is announcing the reopening of the 

comment period for the RFI in order to 

solicit additional comments and request 

responses to specific questions provided 

in the document. The comment period 

for the RFI was originally scheduled to 

end on October 31, 2023. It will now be 

reopened and will end on March 31, 

2024. 

DATES: The comment period for the RFI 

published on October 13, 2023 at 88 FR 

71081 is reopened and extended to 

March 31, 2024. 

FOR FURTHER INFORMATION CONTACT: 

Clary Mole, EMS Specialist, National 

Highway Traffic Safety Administration, 

U.S. Department of Transportation is 

available by phone at (202) 868–3275 or 

by email at Clary.Mole@dot.gov. 

ADDRESSES: Comments must be 

submitted by one of the following 

methods: 

• Federal eRulemaking Portal: go to 

http://www.regulations.gov. Follow the 

online instructions for submitting 

comments. 

• Mail: Docket Management Facility, 

M–30, U.S. Department of 

Transportation, West Building, Ground 

Floor, Rm. W12–140, 1200 New Jersey 

Avenue SE, Washington, DC 20590. 

• Hand Delivery or Courier: West 

Building Ground Floor, Room W12–140, 

1200 New Jersey Avenue SE, between 9 

a.m. and 5 p.m. Eastern Time, Monday 

through Friday, except Federal holidays. 

To be sure someone is there to help you, 

please call (202) 366–9322 before 

coming. 

Regardless of how you submit your 

comments, you must include the docket 

number identified in the heading of this 

document. 

Note that all comments received, 

including any personal information 

provided, will be posted without change 

to http://www.regulations.gov. Please 

see the ‘‘Privacy Act’’ heading below. 

You may call the Docket Management 

Facility at (202) 366–9322. For access to 

the docket to read background 

documents or comments received, go to 

http://www.regulations.gov or the street 

address listed above. We will continue 

to file relevant information in the docket 

as it becomes available. To be sure 

someone is there to help you, please call 

(202) 366–9322 before coming. We will 

continue to file relevant information in 

the Docket as it becomes available. 

Privacy Act: In accordance with 5 

U.S.C. 553(c), DOT solicits comments 

from the public to inform its decisionmaking process. DOT posts these 

comments, without edit, including any 

personal information the commenter 

provides, to http://www.regulations.gov, 

as described in the system of records 

notice (DOT/ALL–14 FDMS), which can 

be reviewed at https://

www.transportation.gov/privacy. 

Anyone is able to search the electronic 

form of all comments received into any 

of our dockets by the name of the 

individual submitting the comment (or 

signing the comment, if submitted on 

behalf of an association, business, labor 

union, etc.). You may review DOT’s 

complete Privacy Act Statement in the 

Federal Register published on April 11, 

2000 (65 FR 19477–78). 

SUPPLEMENTARY INFORMATION: On 

October 13, 2023, NHTSA published a 

RFI to obtain public comments to 

inform EMS Education Agenda 2050, 

and request responses to specific 

questions provided in this document. 

For convenience purposes, NHTSA is 

republishing introductory information, 

background materials and questions 

from its RFI in this notice. 

I. Introductory Information 

In 2012, the National EMS Advisory 

Council (NEMSAC) convened a national 

roundtable meeting on EMS Education 

Agenda for the Future: A Systems 

Approach. In a 2014 report on these 

proceedings, NEMSAC advised that 

stakeholders at the State and local level 

had just begun to experience the full 

impact of the evolution toward a 

national integrated system of education 

for EMS personnel. While stakeholders 

were reticent to move forward with a 

new education agenda, they did provide 

feedback about themes that should be 

considered in the future publication. 

From the feedback collected at the 

meeting, NEMSAC developed 

recommendations to be used in the 

eventual re-envision of the agenda for 

EMS. These recommendations are 

summarized below: 

• Educational content should retain 

the flexibility accorded by the National 

EMS Education standards, but programs 

should use nationally recognized 

evidence-based guidelines to drive local 

curriculum development. 

• The National EMS Information 

System data, evidence-based research, 

and practice analyses should be sourced 

in developing evidence-based 

guidelines and curriculum. 

• Mobile Integrated Healthcare has 

received considerable attention from the 

EMS Community. This and other 

alternative community-based healthcare 


ddrumheller on DSK120RN23PROD with NOTICES1
Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Notices 80811 

delivery models (of the future) should 

evoke an expanded foundational 

knowledge and critical thinking 

capabilities that will poise future EMS 

practitioners to be able to evolve with 

the changing healthcare system or 

rapidly adjust to emerging healthcare 

crises. 

• EMS educators should begin a 

career in academia with expertise in 

adult learning, educational theory, 

curriculum development, and 

competency evaluation but also possess 

experiential knowledge in evidencebased care. 

In the 10 years since NEMSAC’s 

roundtable meeting, the national EMS 

education system continued to evolve— 

especially during the COVID–19 

pandemic. In late 2021, the Federal 

Interagency Committee on EMS 

(FICEMS) began sponsoring listening 

sessions to inform a consensus-driven, 

national report entitled, FICEMS: EMS 

and 911 COVID–19 Response White 

Paper. This publication cited challenges 

and solutions collected during 

stakeholder listening sessions for the 

EMS education system. Among the 

challenges, EMS education stakeholders 

cited scarcity (in some cases deficits) in 

resources for education, rigidity of 

curriculum delivery modalities, the 

increased employer demands on 

students, and inconsistent or delayed 

responses to the needs of the national 

EMS education system as major 

contributors that led to the breakdown 

in the EMS workforce pipeline. 

Prior to the COVID–19 pandemic, 

NHTSA published EMS Agenda 2050: A 

People-centered Vision for the Future of 

EMS (Agenda 2050). This collaborative 

project set a vision for a people-centered 

EMS systems that serves every 

individual in every community across 

the Nation. Later this year, NHTSA and 

its partners will begin a new project to 

develop EMS Education Agenda 2050. 

This project will not replace but build 

upon the achievements of the 2000 EMS 

Education Agenda for the Future: A 

Systems Approach to lead a national 

conversation around the future vision 

for EMS Education and EMS as a 

profession. 

II. Background 

NHTSA, in partnership with Health 

Resources and Services Administration, 

published EMS Education Agenda for 

the Future: A Systems Approach 

(Education Agenda) in 2000. This 

document was founded on the broad 

national EMS education system 

concepts introduced in the EMS Agenda 

for the Future (1996). The Education 

Agenda described a consensus vision of 

an EMS education system with a high 

degree of structure, coordination, and 

interdependence. It proposed a less 

prescriptive system that offered 

educators flexibility in creating a 

student-centered learning environment 

and a process for accommodating future 

advancements in technology and 

medicine. The proposed system 

maximized efficiency, consistency in 

instructional quality, and entry level 

graduate competency by prescribing a 

high degree of structure, coordination, 

and interdependence. To achieve this 

vision, the education system of the 

future centered on five integrated 

primary components: 

• National EMS Core Content 

• National EMS Scope of Practice 

Model 

• National EMS Education Standards 

• National EMS Education Program 

Accreditation 

• National EMS Certification 

After the Education Agenda was 

published, stakeholders began 

implementing their respective 

integrated system components. Almost 

25 years later, the national EMS 

education system has successfully 

evolved into one that exemplifies both 

consistency and flexibility. System 

interdependencies have helped to avoid 

duplication of effort in curriculum and 

education program development, 

evaluating the minimum competencies 

of graduates, certification and licensing 

processes, and facilitation of 

practitioner reciprocity. 

In 2020, the EMS education system 

interdependencies modernized by the 

Education Agenda were tested. 

Challenges presented by the COVID–19 

pandemic forced a variety of 

adaptations. Traditional education 

programs reported a lag in students’ 

capabilities of achieving the 

programmatic competencies 

requirements for graduation. The lag 

was attributed to a variety of causes 

including a focus on pandemic response 

activities over training and education, 

employer demands on working 

students, and the rigidity of in-person, 

classroom-based education delivery 

models. After the majority of programs 

adjusted to the challenges, lags in 

graduation were cured, and students 

achieved programmatic competencies at 

rates similar to those pre-pandemic. The 

response to the pandemic did not 

impact education programs only. The 

impact to EMS agency daily operations 

was felt as well. During the COVID 

pandemic, agencies experienced 

increases in EMS activation and 

response rates which created additional 

stressors for student EMS practitioners 

already working in a high stress job 

environment but also enrolled in an 

EMS education program. These stressors 

were a major contributor to a migration 

of practitioners away from the EMS 

workforce. Agencies and organizational 

stakeholders asserted that it could be 

education program graduation 

requirements causing breakdown in the 

workforce pipeline; however, there were 

no observed decreases in graduation or 

certification testing rates. These 

observations prompt two questions: If 

graduation and certification testing rates 

have remained unchanged, why have 

agencies reported recruitment and 

retention issues? If graduates are not 

entering the EMS workforce, where are 

they finding jobs? 

With agencies experiencing increased 

demand and a deficiency in qualified 

EMS practitioners to respond to it, 

service delivery models had to evolve. 

To bridge the gap in community-based 

care resources, community 

paramedicine and mobile integrated 

healthcare (CP–MIH) service delivery 

models increased in prevalence, and 

improvised training programs were used 

to close new job-specific competency 

gaps among existing EMS practitioners 

and individuals in training. Other 

themes brought to the forefront during 

the pandemic include addressing 

healthcare disparities; the use of EMS 

data as a tool for surveillance and 

nationwide quality of care 

improvements; and a greater value to 

having an EMS workforce that is not 

only equitable, inclusive, and 

accessible, but as diverse as the 

community it serves. These themes, 

evolving service delivery models, and 

the subsequent evolution of 

competencies needed by practitioners 

suggest that it is time for NHTSA to 

gather our partners to begin a new 

conversation about the future of EMS 

Education and EMS as a profession in 

the United States. 

III. Questions Regarding EMS 

Education Agenda 2050 

Responses to the following questions 

are requested to help plan the revision 

of the Education Agenda. Please be as 

specific as possible and as appropriate 

please provide references. 

1. What are the most critical issues 

facing EMS education system that 

should be addressed in the revision of 

the EMS Education Agenda? Please 

provide specific examples. 

2. What progress has been made in 

implementing the EMS Education 

Agenda since 2000? 

3. How have you used EMS Education 

Agenda? Please provide specific 

examples. 


ddrumheller on DSK120RN23PROD with NOTICES1
80812 Federal Register / Vol. 88, No. 222 / Monday, November 20, 2023 / Notices 

4. As an EMS Stakeholder, how might 

a revised EMS Education Agenda be 

most useful to you? 

5. What significant changes have 

occurred in the EMS education system 

at the national, Federal, State, and local 

levels since 2000? 

6. What significant changes will 

impact the EMS education system in the 

next 25 years? 

7. How might the revised EMS 

Education Agenda contribute to 

enhanced EMS for children? 

8. How might the revised EMS 

Education Agenda support and/or 

promote data-driven and evidencebased improvements in EMS education 

systems and EMS practitioner practice? 

9. How could the revised EMS 

Education Agenda enhance 

collaboration among EMS systems, 

health care providers and facilities, 

public safety answering points, public 

health, public safety, emergency 

management, insurers, and others? 

10. How could the revised EMS 

Education Agenda be used to promote 

community sustainability and 

resilience? 

11. How could the revised EMS 

Education Agenda contribute to 

improved coordination for disaster 

response, recovery, preparedness, and 

mitigation? 

12. How could the revised EMS 

Education Agenda enhance the 

exchange of evidence-based practices 

between national, Federal (and 

military), State, and local levels? 

13. How could the revised EMS 

Education Agenda support the seamless 

and unimpeded transfer of military EMS 

personnel to roles as civilian EMS 

providers? 

14. How could the revised EMS 

Education Agenda support interstate 

credentialing of EMS personnel? 

15. How could the revised EMS 

Education Agenda support improved 

patient outcomes in rural and frontier 

communities? 

16. How could the revised EMS 

Education Agenda lead to improved 

EMS systems in tribal communities? 

17. How could the revised EMS 

Education Agenda promote a culture of 

safety among EMS personnel, agencies, 

and organizations? 

18. Are there additional EMS 

attributes that should be included in the 

revised EMS Education Agenda? If so, 

please provide an explanation for why 

these additional EMS attributes should 

be included. 

19. Are there EMS attributes in the 

2000 EMS Education Agenda that 

should be eliminated from the revised 

edition? If so, please provide an 

explanation for why these EMS 

attributes should be eliminated. 

20. What are your suggestions for the 

process that should be used in revising 

the EMS Education Agenda? 

21. What specific agencies/ 

organizations/entities are essential to 

involve, in a revision of the EMS 

Education Agenda? 

22. Do you have any additional 

comments regarding the revision of the 

EMS Education Agenda? 

(Authority: 23 U.S.C. 403(b)(1)(A)(iv); 49 CFR 

1.95; 501.8) 

Issued in Washington, DC. 

Nanda Narayanan Srinivasan, 

Associate Administrator, Research and 

Program Development. 

[FR Doc. 2023–25551 Filed 11–17–23; 8:45 am] 

BILLING CODE 4910–59–P 

DEPARTMENT OF THE TREASURY 

Office of Foreign Assets Control 

Notice of OFAC Sanctions Action 

AGENCY: Office of Foreign Assets 

Control, Treasury. 

ACTION: Notice 

SUMMARY: The U.S. Department of the 

Treasury’s Office of Foreign Assets 

Control (OFAC) is publishing the name 

of one person that has been placed on 

OFAC’s Specially Designated Nationals 

and Blocked Persons List (SDN List) 

based on OFAC’s determination that one 

or more applicable legal criteria were 

satisfied. All property and interests in 

property subject to U.S. jurisdiction of 

this person are blocked, and U.S. 

persons are generally prohibited from 

engaging in transactions with them. 

DATES: See SUPPLEMENTARY INFORMATION

section for applicable date(s). 

FOR FURTHER INFORMATION CONTACT: 

OFAC: Bradley T. Smith, Director, tel.: 

202–622–2490; Associate Director for 

Global Targeting, tel.: 202–622–2420; 

Assistant Director for Licensing, tel.: 

202–622–2480; Assistant Director for 

Regulatory Affairs, tel.: 202–622–4855; 

or the Assistant Director for Sanctions 

Compliance & Evaluation, tel.: 202–622– 

2490. 

SUPPLEMENTARY INFORMATION: 

Electronic Availability 

The SDN List and additional 

information concerning OFAC sanctions 

programs are available on OFAC’s 

website (https://www.treasury.gov/ofac). 

Notice of OFAC Actions 

A. On November 7, 2023, OFAC 

determined that the property and 

interests in property subject to U.S. 

jurisdiction of the following persons are 

blocked under the relevant sanctions 

authority listed below. 

Individuals 

1. CAMACHO PORCHAS, Jesus 

Francisco (a.k.a. ‘‘Pilo’’), Hermosillo, 

Sonora, Mexico; DOB 11 May 1980; POB 

Sonora, Mexico; nationality Mexico; 

Gender Male; C.U.R.P. 

CAPJ800511HSRMRS01 (Mexico) 

(individual) [ILLICIT–DRUGS– 

EO14059]. 

Designated pursuant to section 1(a)(i) 

of Executive Order 14059 of December 

15, 2021, ‘‘Imposing Sanctions on 

Foreign Persons Involved in the Global 

Illicit Drug Trade,’’ 86 FR 71549 

(December 17, 2021) (E.O. 14059) for 

having engaged in, or attempted to 

engage in, activities or transactions that 

have materially contributed to, or pose 

a significant risk of materially 

contributing to, the international 

proliferation of illicit drugs or their 

means of production. 

2. CHAVARIN PRECIADO, David 

Alonso (a.k.a. ‘‘Chava’’), Nogales, 

Sonora, Mexico; DOB 29 Dec 1982; POB 

Mexico; nationality Mexico; Gender 

Male; R.F.C. CAPD821229IG4 (Mexico) 

(individual) [ILLICIT–DRUGS– 

EO14059]. 

Designated pursuant to section 1(a)(i) 

of E.O. 14059 for having engaged in, or 

attempted to engage in, activities or 

transactions that have materially 

contributed to, or pose a significant risk 

of materially contributing to, the 

international proliferation of illicit 

drugs or their means of production. 

3. HERNANDEZ MAZON, Sergio 

Isaias (a.k.a. ‘‘Chavelo’’), Calle Estribo 3, 

Colonia El Rodeo, Nogales, Sonora, 

Mexico; DOB 23 Aug 1980; POB Sonora, 

Mexico; nationality Mexico; Gender 

Male; C.U.R.P. HEMS800823HSRRZR07 

(Mexico) (individual) [ILLICIT–DRUGS– 

EO14059]. 

Designated pursuant to section 1(a)(i) 

of E.O. 14059 for having engaged in, or 

attempted to engage in, activities or 

transactions that have materially 

contributed to, or pose a significant risk 

of materially contributing to, the 

international proliferation of illicit 

drugs or their means of production. 

4. MENESES OSPINA, Cristian Julian, 

Mexico; DOB 31 Dec 1983; POB Ibague, 

Colombia; nationality Colombia; Gender 

Male; Cedula No. 14137405 (Colombia); 

C.U.R.P. MEOC831231HNENSR06 

(Mexico) (individual) [ILLICIT–DRUGS– 

EO14059]. 

Designated pursuant to section 1(a)(i) 

of E.O. 14059 for having engaged in, or 

attempted to engage in, activities or 

transactions that have materially 


ddrumheller on DSK120RN23PROD with NOTICES1